Abstract
Abstract
Background
Surgical handover is associated with a significant risk of care failures. Existing research displays methodological deficiencies and little consensus on the outcomes that should be used to evaluate interventions in this area. This paper reports a protocol to develop a core outcome set (COS) to support standardisation, comparability, and evidence synthesis in future studies of surgical handover between doctors.
Methods
This study adheres to the Core Outcome Measures in Effectiveness Trials (COMET) initiative guidance for COS development, including the COS-Standards for Development (COS-STAD) and Reporting (COS-STAR) recommendations. It has been registered prospectively on the COMET database and will be led by an international steering group that includes surgical healthcare professionals, researchers, and patient and public partners. An initial list of reported outcomes was generated through a systematic review of interventions to improve surgical handover (PROSPERO: CRD42022363198). Findings of a qualitative evidence synthesis of patient and public perspectives on handover will augment this list, followed by a real-time Delphi survey involving all stakeholder groups. Each Delphi participant will then be invited to take part in at least one online consensus meeting to finalise the COS.
Ethics and dissemination
This study was approved by the Royal College of Surgeons in Ireland (RCSI) Research Ethics Committee (202309015, 7th November 2023). Results will be presented at surgical scientific meetings and submitted to a peer-reviewed journal. A plain English summary will be disseminated through national websites and social media. The authors aim to integrate the COS into the handover curriculum of the Irish national surgical training body and ensure it is shared internationally with other postgraduate surgical training programmes. Collaborators will be encouraged to share the findings with relevant national health service functions and national bodies.
Discussion
This study will represent the first published COS for interventions to improve surgical handover, the first use of a real-time Delphi survey in a surgical context, and will support the generation of better-quality evidence to inform best practice.
Trial registration
Core Outcome Measures in Effectiveness Trials (COMET) initiative 2675. http://www.comet-initiative.org/Studies/Details/2675.
Funder
Bon Secours Hospital in Dublin, Ireland, via the Royal College of Surgeons in Ireland (RCSI) StAR MD Programme
Publisher
Springer Science and Business Media LLC
Reference20 articles.
1. Cohen MD, Hilligoss PB. The published literature on handoffs in hospitals: deficiencies identified in an extensive review. Qual Saf Health Care. 2010;19(6):493–7. https://doi.org/10.1136/qshc.2009.033480.
2. Bigham MT, Logsdon TR, Manicone PE, et al. Decreasing handoff-related care failures in children’s hospitals. Pediatrics. 2014;134(2):e572–9. https://doi.org/10.1542/peds.2013-1844.
3. Horwitz LI, Moin T, Krumholz HM, Wang L, Bradley EH. Consequences of inadequate sign-out for patient care. Arch Intern Med. 2008;168(16):1755–60.
4. Committee on Acute Care Surgery, Canadian Association of General Surgeons. Clinical practice guideline: dynamic practice guidelines for emergency general surgery. 2018. Available at: https://cags-accg.ca/wp-content/uploads/2018/11/ACS-Handbook-CPG-Ch-1-Rounding-and-Handover.pdf. Accessed 20 Mar 2023.
5. Abdellatif A, Bagian JP, Barajas ER, et al. Communication during patient hand-overs: patient safety solutions, volume 1, solution 3, May 2007. Jt Comm J Qual Patient Saf. 2007;33(7):439–42.